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The effect of zoledronic acid and high-dose vitamin D on function after hip fractures. A prospective cohort study

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Abstract

Purpose

Hip fractures are associated with functional decline and increased mortality. The aim of this study was to investigate the effect of zoledronic acid and high-dose vitamin D on function and mortality after hip fractures.

Patients and methods

Forty-five patients received zoledronic acid and high dose of vitamin D during hospitalization after fracture management. These patients were compared with a control group of 46 patients. Pre- and postoperative prospectively collected data including ASA score, Charlson comorbidity score, presence of dementia, Vitamin D, and the Barthel index were available. Final follow-up was performed after one year. Primary outcome was patients’ function at final follow-up as measured with Barthel index score. Secondary outcomes included mortality, assessment of pain, and complications.

Results

Barthel index score at final follow-up was decreased in both groups. There was no significant difference in Barthel index between the two groups (15.5 ± 5.0 vs 15.8 ± 5.8, p = 0.850). However, the Barthel index in the control group decreased beyond the smallest detectable change (3 points). Mortality was statistically different between groups (8.8% vs 28.2%, p = 0.047). Complications and pain at final follow-up were not different between groups. Multivariate analysis revealed that preoperative Barthel index and Charlson comorbidity score independently affected function at final follow-up. Logistic regression analysis disclosed that not receiving active treatment and complications were associated with increased mortality.

Conclusions

Medical treatment after surgical management of hip fractures results in reduced mortality and lessens the functional decline associated with these fractures.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery & Musculoskeletal Trauma, Faculty of Medicine, University of Thessaly, Biopolis, 41500, Larissa, Greece

    Antonios A. Koutalos, George I. Chalatsis, Georgios Varsanis, Konstantinos N. Malizos & Theofilos Karachalios

Authors
  1. Antonios A. Koutalos
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  2. George I. Chalatsis
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  3. Georgios Varsanis
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  4. Konstantinos N. Malizos
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  5. Theofilos Karachalios
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Corresponding author

Correspondence to Antonios A. Koutalos.

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The scientific and ethical committee of the hospital was informed and gave permission for the undertaking of the study.

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All patients gave their consent for participating in the study.

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Koutalos, A.A., Chalatsis, G.I., Varsanis, G. et al. The effect of zoledronic acid and high-dose vitamin D on function after hip fractures. A prospective cohort study. Eur J Orthop Surg Traumatol 32, 1145–1152 (2022). https://doi.org/10.1007/s00590-021-03092-z

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  • DOI: https://doi.org/10.1007/s00590-021-03092-z

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